@article{534c9a5411fe4c2395654fa65cda15d6,
title = "Coadministration of Immunosuppressant Treatments With Pegloticase in the Context of Solid-Organ Transplantation and Gout: A Case Report",
abstract = "Refractory gout can be treated with infusions of pegloticase, which metabolizes uric acid into a product readily excreted in urine. Antidrug antibodies often develop, leading to reduced efficacy and potential infusion reactions. The concomitant administration of immunosuppressive agents has been suggested as a means of mitigating the effects of drug-related immunogenicity, rendering treatment more tolerable, and resulting in better outcomes. This report presents cases of 2 patients with tophaceous gout, each having previously undergone a solid-organ transplant, each taking immunosuppressants to prevent organ rejection, and each successfully treated with pegloticase. Although data from randomized controlled studies are needed, these cases suggest that it may be beneficial to coadminister an immunosuppressive medication to extend drug persistence with pegloticase in the management of refractory gout. This approach could allow patients to receive long-term treatment, resulting in improved patient outcomes.",
keywords = "Immunogenicity, Monosodium urate crystals, Uric acid",
author = "Anna Kilzer and Lauren Klingemann and Mikuls, {Ted R.} and Thiele, {Geoffrey M.} and Alison Petro and Michael Feely",
note = "Funding Information: From the 1Division of Rheumatology and Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska; and the 2Department of Medicine, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA Acknowledgements: The authors thank Dr. Cynthia Schmidt with the Leon S. McGoogan Health Sciences Library for her assistance with citations and references. Funding for this work was provided by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism grant R25AA020818 through the Summer Undergraduate Alcohol Research Program at the University of Nebraska Medical Center. The funders had no role in the design or conduct of this study and no input on the report. Dr. Mikuls has received research funding from and has served as an advisor to Horizon Therapeutics. *Anna Kilzer and Lauren Klingemann contributed equally to this work. Corresponding author: Michael Feely, Division of Rheumatology and Immunology, Department of Internal Medicine, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA Publisher Copyright: {\textcopyright} Ba{\c s}kent University 2022 Printed in Turkey. All Rights Reserved.",
year = "2022",
month = dec,
doi = "10.6002/ECT.2022.0046",
language = "English (US)",
volume = "20",
pages = "1122--1125",
journal = "Experimental and Clinical Transplantation",
issn = "1304-0855",
publisher = "Baskent University",
number = "12",
}